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. 2023 Dec;17(6):2721-2728.
doi: 10.1007/s11701-023-01702-y. Epub 2023 Aug 27.

Improved urinary continence recovery after robot-assisted radical prostatectomy with lateral pelvic fascia preservation

Masaki Shiota  1 , Shigehiro Tsukahara  2 , Shohei Ueda  2 , Jun Mutaguchi  2 , Shunsuke Goto  2 , Satoshi Kobayashi  2 , Takashi Matsumoto  2 , Leandro Blas  2 , Keisuke Monji  2 , Junichi Inokuchi  2 , Masatoshi Eto  2
Affiliations

Improved urinary continence recovery after robot-assisted radical prostatectomy with lateral pelvic fascia preservation

Masaki Shiota et al. J Robot Surg. 2023 Dec.

Abstract

The novel technique of lateral pelvic fascia preservation (LPFP) in robot-assisted radical prostatectomy (RARP) has been reported to improve urinary continence recovery. We aimed to investigate surgical and oncological outcomes after RARP using the LPFP technique and compare them with conventional RARP. This study included patients who underwent RARP with and without the LPFP technique. Time to urinary continence recovery was compared between the LPFP and non-LPFP groups using univariate, multivariate, and propensity-score matched analysis. Perioperative and postoperative outcomes were compared between the two groups using univariate analysis. We included 139 patients who underwent RARP, 68 in the LPFP group and 71 in the non-LPFP group. The LPFP technique was associated with a shorter time to urinary continence recovery, a shorter operative time and lower estimated blood loss. Surgical and oncological outcomes, including complications, pathological T-stage, surgical margin status, and biochemical recurrence-free survival, were comparable between the two groups. This study demonstrated that the LPFP technique improves urinary continence recovery and operative times without compromising surgical and oncological outcomes. The use of this technique in patients with clinically localized prostate cancer is recommended.

Keywords: Lateral pelvic fascia preservation; Prostate cancer; Robot-assisted radical prostatectomy; Urinary continence.

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